Dozens of providers in D.C. offer free or reduced-cost mental health care to residents who qualify for Medicaid. It’s also pretty easy to get connected: Prospective patients can visit D.C.’s Department of Behavioral Health in person or call the Access HelpLine to get matched with any one of the 40 city-certified community-based providers, or Core Services Agencies.
One such provider is Kinara Health and Home Care Services, LLC. It’s certified by DBH and received over $1.1 million in public dollars this year to provide care for some of the city’s most vulnerable patients. Kinara reports and bills to both DBH and Medicaid, the insurance program for people who are low-income or disabled.
But in interviews, eight former Kinara patients—all of whom were either experiencing homelessness or struggling with mental health problems—and two former workers describe troubling practices at Kinara:
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A patient says the housing liaison misled her into thinking he was a doctor.
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Two patients experiencing homelessness say an outreach worker threatened to beat them up for not turning down their music.
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Kinara outreach workers stand outside homeless shelters trying to recruit new patients, a practice seasoned experts in this work found odd. Meanwhile, Kinara’s founder says anyone can perform outreach.
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Patients believed they’d receive money or housing but left disappointed. (Kinara management denies the provider ever promises money or housing.)
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A patient experiencing homelessness says his case manager laughed at him while he was having a manic episode.
Alex Antonio Robinson Sr. regrets asking for help.
Robinson, who is 40, lives in his car and sometimes stays at Catholic Charities on Martin Luther King Jr. Avenue SE. He struggles with mental health problems, and has used services at various local providers, like Green Door and Holy Health Care Behavioral Services, and was admitted to the Psychiatric Institute of Washington several times for suicidal ideation.
“Kinara has been the worst,” he tells City Desk outside of Catholic Charities on New York Avenue NE.
He says it was always hard to reach his case manager, who he refers to as Ms. J. “Because I’m not your only case … I don’t call you when I want something, I call you when I need something.” The last time he saw Ms. J, Robinson says, she laughed at him as he was having a manic episode.
Robinson has been diagnosed with schizophrenia, bipolar disorder, depression, and anxiety. “As a man, I don’t want to feel like I have mental health issues, but I know what’s real.” So he takes medication to treat his various illnesses: trazodone, quetiapine, sertraline, and valproic acid.
When he ran out of his medication on Oct. 24, he asked his case manager to help him get more. Kinara writes prescriptions and helps patients pick up their medicine if they can’t do it themselves. Robinson called Ms. J because he couldn’t operate a car in his condition and didn’t have enough money for Metro fare.
After many failed attempts, he says, she agreed to meet him. When Ms. J arrived, with a minor accompanying her, she refused to get out of the car or let Robinson inside. At one point she instructed Robinson’s friend, who was there that day with him, to snap photos so he could see himself, suggesting he looked bad. Ms. J ended up giving Robinson’s friend $20 to help him get his medication.
“She had the nerve to be laughing and telling [my friend], I’m not getting into her car,” he says. Robinson’s friend confirms what happened.
After the incident, Robinson texted his case manager: “You laughed at my misery and shame. then you told my friend to take a picture. thanks, reporting you tomorrow. I need help and people like you are why I never ask or get it. God Bless you.” Robinson showed City Desk the text, which Ms. J did not reply to, and the photos taken of him.
“Kinara has still not gotten my medicine, and this weekend, I thought about suicide,” he says. “All I’m asking for is help. I don’t know where to find it right now.” When City Desk spoke with Robinson on Nov. 4, he was jittery throughout the interview. He took breaks several times during the conversation because he noticed himself get irritable.
Kinara management says they were not aware of the aforementioned incident. They declined to make the caseworker available for comment. But when problems do arise, they say, they are quick to address them.
“I feel good about our internal reporting process and the way that we manage something as long as things are brought to our attention,” says Samantha Slater, a clinician at Kinara who handles compliance. “Our internal reporting process is pretty immediate and pretty comprehensive. Our records are DBH’s records.”
Slater says Kinara recently reported its sole housing liaison, Alfonso Padron, to DBH after he, according to multiple accounts, misled a patient into thinking he was a doctor. Padron denies ever telling anyone he was a doctor. When City Desk reached out to DBH for comment on complaints against Padron, and all the complaints City Desk turned up against Kinara, a spokeswoman responded, “As of 11/21/2019, DBH has no record of complaints regarding Kinara Health [and] Home Health Care.”
LaQuida Tate says she first met Padron at a church in Northwest D.C. while she was trying to help someone who was wrestling with addiction get a birth certificate and a Social Security card. “I told him I needed help myself,” says Tate. She was also struggling with addiction, and Padron suggested Kinara could help.
“He acted like a doctor,” Tate says of Padron. She even called him “Dr. Alfonso,” and he’d respond. Padron advised Tate to take time off work over the summer so he could get her into a rehab and detox program. She listened.
When she finally visited Kinara’s office in-person, “raising hell” for failing to put her into treatment and neglecting to fill out paperwork she needed to return to work, Tate learned Padron wasn’t a doctor. Kinara staff later apologized in an emailed letter to Tate.
City Desk reached out to Padron, who says he never explicitly told anyone he was a doctor. But he says patients sometimes assumed he was because of the way he carried himself. Kinara management says they scheduled a meeting with Padron once they learned of the incident. “He had done some things that were outside of compliance with HIPAA and then we had got word that he had been representing himself to consumers as a doctor,” says Slater. She says Padron quit Kinara; he confirmed this. Padron now works for another CSA called District Healthcare Services in Southeast D.C.
“It is still a struggle,” says Tate. “I ended up being worse off than when I started.” Tate’s employer fired her in mid-November, citing scheduling problems. Her employer says she took too much paid time off. She says she’s doing better, but with help she got herself. Based on her own experience, Tate finds herself questioning Kinara’s intentions: “Are you really here to help or are you here to get money?”
The government pays Kinara for providing patients a diagnostic or assessment, medication or somatic treatment, counseling, and community support. Like most doctors’ offices, Kinara bills when patients see medical staff. It also bills for case managers’ work. Case managers submit basic notes they take on meeting with patients so providers can get paid, as is customary in this type of social work.
Housing is not one of Kinara’s main objectives. “It’s something that we try to serve and speak to because it’s so prevalent across the population that we see,” says Slater. “If consumers come in and say ‘I’m not looking for mental health services, I’m looking for housing,’ we are not going to see them because that’s not our main mission.”
Some patients have gotten a different impression.
Gilbert Morgan, for example,primarily sought Kinara’s help for housing assistance. Morgan is a retired mechanic who has stayed at Catholic Charities on New York Avenue NE ever since his former girlfriend kicked him out of their home last Christmas. He left a DBH-certified CSA called Abundant Grace Health Services after a man doing outreach for Kinara introduced him to the agency. After a few months with Kinara, Morgan says his case manager was unhelpful, albeit nice. He cites a time when she arranged to have them visit a unit, but when they arrived nothing was actually available to rent.
“They said they would help get me a place but never did. They just wanted me to see a doctor … They wanted to prescribe me medication. I was like ‘Hell nah, you are not going to prescribe me medication,’” says Morgan. “If no one is going to help me get out of here, I’m going to take my [Social Security] check and I’m going to find a place to live.”
Shandy Iyles also left Kinara disappointed. Iyles first learned of Kinara when she was getting help at So Others Might Eat, an organization that serves residents experiencing homelessness and poverty. A woman outside SOME approached Iyles to tell her about a health care provider she works for—Kinara—that gives patients money and helps them with housing.
Desperate for help, Iyles gave it a chance. She brought along her sister-in-law, Alicia Williams, who is also homeless, when she paid Kinara a visit. After using its services since the beginning of summer and into the fall, Iyles says Kinara ultimately did not help her. “My daughter would just wait around and wait around for them to show. They didn’t show. They just weren’t consistent on what they were supposed to do for her,” says Alicia’s mother, Savannah Williams.
During their time with Kinara, a person who performed outreach on behalf of Kinara threatened the two women. Williams tells City Desk that this outreach worker said she’d call family members to “beat my ass.” The incident occurred while the two women were in Kinara’s van, playing music. (Kinara drives patients to daily appointments if they cannot get places themselves.) The outreach worker, who brought her grandson to work that day, told them they couldn’t play their music. When they refused to listen, the outreach worker started threatening them, Iyles and Williams separately tell City Desk.
“They need to shut it down,” says Iyles. “They are using people with mental health.”
The outreach worker could not be located for comment, and Kinara says this worker was never technically employed there.
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Kinara employs roughly 30 people, including four medical doctors, and serves no more than 300 patients. It’s a young agency. The provider first registered with the Department of Consumer and Regulatory Affairs in June 2017. Kinara has been DBH-certified for the last two years.
“We play by the book here. We have our set of trainings that we do weekly and biweekly,” says Kinara CEO Dr. Eban Ebai. “Most of our consumers are from Southeast … So for someone to drive from Southeast and get services here, you must know the services are good, because there are so many CSAs there in Southeast.” Kinara is located at 7603 Georgia Ave. NW.
Minimal information about Kinara is available online. Its website only provides general information—a lot of stock photos but nothing too specific, especially as compared to similar certified CSAs that list employees, specialities, and the populations they serve. Amazing Love Health Services in Northeast, for example, lists the names and titles of clinical staff on its website, along with years of experience. Latin American Youth Center focuses on low-income young people, ages 11 to 24, per its website. And Absolute Healthcare Resources, based in Fairfax, even details what is expected of case managers on its website.
The District government is Kinara’s main client, says Ebai. While the mental health care provider says it doesn’t target the homeless population, this group makes up a significant portion of Kinara’s case load given that people experiencing homelessness disproportionately suffer from severe mental illness. Kinara’s outreach team has recruited consumers at homeless shelters, according to various patients and one former worker.
Kinara management maintains that the company’s outreach workers aren’t employees of Kinara, technically speaking. They say that the worker who was in a Kinara van with Iyles and Williams, for example, did outreach with the promise of getting permanent employment if she proved herself.
“Anyone could be outreach, you could be outreach,” Jacqueline Adoko, Kinara owner and founder, tells City Desk. She described how it works, citing another outreach worker, Fern Collins, as an example: “Everytime that she goes around and does outreach and comes back with consumers, she gives us a list of the people she brings and how much she has spent on gas. And then calculates it and we pay her.”
Kinara management also denies that it ever gave patients money, as Iyles, otherpatients, and Collins say.“I’ve heard it is common among newer CSAs to do that or give out a travel stipend—that does happen. But that’s not happening here,” says Slater.
Collins actually stopped working at Kinara, citing the way it treated patients during her time there, which lasted between May and September. Kinara management say they and Collins parted on bad terms because Collins couldn’t complete all the requirements to be a permanent employee and presented a faulty background check. But Collins, who currently works as a case manager at another DBH-certified CSA called Life Enhancement Services, says Kinara slow-walked the employment process, not her. She also claims Kinara owes her money for work. Collins says she reported Kinara to theOffice of Accountability at DBH; this office referred City Desk’s questions to a DBH spokesperson, who says the agency received no complaints about the provider.
Collins was deeply disturbed by what she saw happening at Kinara, including staff reactions to the death of one of its former patients, Eric Carter. Carter fatally shot his brother and was immediately killed by police on Sept. 16. Carter had gone to Kinara roughly one week before the shooting because he was struggling with mental illness that spiraled out of control after he became addicted to pain medication, says his sister Renee Carter. After Kinara staff learned about the incident on the news, staff did not immediately reach out to the family.
“You aren’t going to reach out to the family and send your condolences. Y’all are making enough money off of him, why not?” says Collins. “So I went on my own to visit his mom and his sister. I took her to 801 [East Men’s Shelter] to get her brother’s belongings from there.”
Renee confirms that Kinara staff did not contact her until more than two weeks after the shooting. When they finally did, they gave her a Walmart gift card.
“If Eric was treated, he wouldn’t have shot his brother or got himself killed,” Renee says.
Renee has a lot of questions about what happened—namely, did Eric actually get the care he sought? Eric’s girlfriend thought he was acting funny, so he went to see a therapist at Kinara. Renee says he went in for medication on Sept. 4, but did not receive it because Kinara was going to observe him. Renee has been meeting with a lawyer to see how she can get more answers. When she called Kinara to get access to his medical records after her brother’s death, the receptionist said Eric’s file is no longer in the system.
Kinara management says it immediately contacted DBH when they learned about Eric’s death. Slater says, “we cannot comment on specifics … [but] there’s been no investigation or wrongdoings by our governing body on that.”
Based on conversations she’s had with staff, Collins says Kinara is not sensitive to the populations they serve. But she also says Kinara is “operating in a system that’s designed to fail” because, like other CSAs, it is more concerned about “getting as many consumers as possible.”
Collins references a patient she met while doing outreach named Reginal Pickett. Pickett, who is homeless, has been with a CSA for the last three years. When City Desk spoke with Pickett, he explained that he does not have a birth certificate or Social Security card. It’s hard to get a job or housing without proof of identification. Collins says his case manager should have helped him with that because Pickett struggles to read or write.
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Generally speaking, CSAs—case managers in particular—have a lot of autonomy due to the nature of the work. Agencies give case managers a lot of flexibility because the populations they serve demand extraordinary attention.
Ann Marie Staudenmaier, a lawyer for the Washington Legal Clinic for the Homeless, has never heard of Kinara but says the number of bad case managers she’s encountered over the years is countless. Her two cents: “They think they can get away with it because no one is going to report it or no one is going to believe it.” Staudenmaier also says the way CSAs operate largely remains a mystery to her, even though she works with a lot of clients who are experiencing homelessness.
“My jaded view of this after being here for 23 years, there are just scam artists out there who get huge government contracts and they are not really doing what they are paid to do,” says Staudenmaier. “Some of these agencies, they try hard. We are talking about a population that is difficult to keep track of … folks who need help with a lot of different aspects of their lives. But I think a lot of them are getting a lot of money to do stuff they aren’t really doing.”
When City Desk asked if Kinara needed more support—perhaps, case managers are overwhelmed—Ebai was quick to reply: “We are fine.”
There is a learning curve to this type of work, says one case manager who works for an established social service organization that helps the homeless in D.C. That’s why a CSA might, for example, try and recruit patients outside shelters. He found the practice odd—the idea of a CSA sending workers to act as a kind of “sales representative”—but read it as a CSA being newer and less experienced.
“There is definitely a difference between an agency that is up-and-coming … and one that is overly preying on available money and exploitable populations,” he says.
Meanwhile, patients in need feel shortchanged. John Ifeanyi, for one, feels this way. He is 61 and lost everything after being laid off from his security job, and now also stays at Catholic Charities on New York Avenue NE. Ifeanyi says his case manager at Kinara promised to help him get a job but hasn’t been helpful. “I discovered he was not serious,” says Ifeanyi. “I stopped answering his calls.”
Ifeanyi has lost faith in the government, and finds solace in the church instead.